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Drug Overdose

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https://www.readbyqxmd.com/read/28816830/fatal-cerebral-edema-seizures-and-hyponatremia-after-trazodone-overdose
#1
Jose David Avila
Trazodone is a serotonin antagonist and reuptake inhibitor that is widely used for the treatment of depression and insomnia. Fatal overdose is rare and usually occurs when combined with other drugs or alcohol. Only a few lethal cases of pure trazodone overdose have been reported, all attributed to cardiotoxicity. We reported a 37-year-old woman who presented after ingesting 6.45 g of trazodone in a suicidal attempt. She was hyponatremic because of the syndrome of inappropriate antidiuretic hormone secretion and, shortly after, had a seizure and developed fatal cerebral edema...
August 14, 2017: Clinical Neuropharmacology
https://www.readbyqxmd.com/read/28815428/the-pharmacology-and-toxicology-of-third-generation-anticonvulsant-drugs
#2
REVIEW
Paul LaPenna, Laura M Tormoehlen
Epilepsy is a neurologic disorder affecting approximately 50 million people worldwide, or about 0.7% of the population [1]. Thus, the use of anticonvulsant drugs in the treatment of epilepsy is common and widespread. There are three generations of anticonvulsant drugs, categorized by the year in which they were developed and released. The aim of this review is to discuss the pharmacokinetics, drug-drug interactions, and adverse events of the third generation of anticonvulsant drugs. Where available, overdose data will be included...
August 16, 2017: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://www.readbyqxmd.com/read/28804788/pro-dopamine-regulator-kb220-to-balance-brain-reward-circuitry-in-reward-deficiency-syndrome-rds
#3
Kenneth Blum, Marcelo Febo, Lyle Fried, David Baron, Eric R Braverman, Kristina Dushaj, Mona Li, Zsolt Demetrovics, Rajendra D Badgaiyan
We are faced with a worldwide opiate/opioid epidemic that is devastating. According to the Centers for Disease Control and Prevention (CDC), at least 127 people, young and old, are dying every day in America due to narcotic overdose. The Food and Drug Administration (FDA) has approved Medication-Assisted Treatments (MATs) for opiate/opioids as well as alcohol and nicotine. The mechanism of action of most MATS favors either blocking of dopaminergic function or a form of Opiate Substitution Therapy (OST). These treatment options are adequate for short-term treatment of the symptoms of addiction and harm reduction but fail long-term to deal with the cause or lead to recovery...
2017: Journal of Reward Deficiency Syndrome and Addiction Science
https://www.readbyqxmd.com/read/28801266/lipogels-responsive-to-near-infrared-light-for-the-triggered-release-of-therapeutic-agents
#4
Francisco Martín-Saavedra, Eduardo Ruiz-Hernández, Clara Escudero-Duch, Martin Prieto, Manuel Arruebo, Negar Sadeghi, Roel Deckers, Gert Storm, Wim E Hennink, Jesús Santamaría, Nuria Vilaboa
Here we report a composite system based on fibrin hydrogels that incorporate in their structure near-infrared (NIR) responsive nanomaterials and thermosensitive liposomes (TSL). Polymerized fibrin networks entrap simultaneously gold-based nanoparticles (NPs) capable of transducing NIR photon energy into heat, and lysolipid-incorporated TSL (LTSL) loaded with doxorubicin hydrochloride (DOX). NIR irradiation of the resulting hydrogels (referred to as "lipogels") with 808 nm laser light increased the temperature of the illuminated areas, leading to the release of the liposomal cargo...
August 8, 2017: Acta Biomaterialia
https://www.readbyqxmd.com/read/28799847/the-willingness-of-people-who-inject-drugs-in-boston-to-use-a-supervised-injection-facility
#5
Casey León, Lena Cardoso, Sarah Mackin, Barry Bock, Jessie M Gaeta
BACKGROUND: In Massachusetts, the number of opioid-related deaths has increased 350% since 2000. In the setting of increasing overdose deaths, one potential intervention is Supervised Injection Facilities (SIFs). This study explores willingness of people who inject drugs in Boston to use a SIF and examines factors associated with willingness. METHODS: A cross-sectional survey of a convenience sample of 237 people who inject drugs and utilize Boston's needle exchange program (NEP)...
August 11, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28799408/assessment-of-apixaban-prescribing-patterns-for-nonvalvular-atrial-fibrillation-in-hospitalized-patients
#6
Caitlin M Gibson, Carmen B Smith, Sondra Davis, Michael J Scalese
BACKGROUND: Apixaban is a direct oral anticoagulant (DOAC) for the prevention of stroke and systemic embolism in patients with nonvalvular atrial fibrillation (NVAF). Other DOACs require renal dose adjustments based solely on creatinine clearance. Apixaban differs in that its dose adjustments are more complex, potentially leading to prescribing errors. OBJECTIVE: To determine if adherence to Food and Drug Administration (FDA)-approved dosing for apixaban is maintained in hospitalized patients with NVAF...
August 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28799198/does-paying-service-providers-by-results-improve-recovery-outcomes-for-drug-misusers-in-treatment-in-england
#7
Andrew Jones, Matthias Pierce, Matt Sutton, Thomas Mason, Tim Millar
AIM: To compare drug recovery outcomes in commissioning areas included in a 'payment by results' scheme with all other areas. DESIGN: Observational and data linkage study of the National Drug Treatment Monitoring System, Office for National Statistics mortality database, and Police National Computer criminal records, for two years before and after introduction of the scheme. Pre-post controlled comparison compared outcomes in participating versus non-participating areas following adjustment for drug use, functioning and drug treatment status...
August 10, 2017: Addiction
https://www.readbyqxmd.com/read/28797652/geographic-variation-in-opioid-and-heroin-involved-drug-poisoning-mortality-rates
#8
Christopher J Ruhm
INTRODUCTION: An important barrier to formulating effective policies to address the rapid rise in U.S. fatal overdoses is that the specific drugs involved are frequently not identified on death certificates. This analysis supplies improved estimates of state opioid and heroin involved drug fatality rates in 2014, and changes from 2008 to 2014. METHODS: Reported mortality rates were calculated directly from death certificates and compared to corrected rates that imputed drug involvement when no drug was specified...
August 1, 2017: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/28796591/utilization-of-buprenorphine-and-methadone-among-opioid-users-who-inject-drugs
#9
Judith I Tsui, Richard Burt, Hanne Thiede, Sara N Glick
BACKGROUND: There has been a rise in opioid abuse and related injection drug use in the United States and treatment for opioid use disorders may be underutilized. The study aim was to describe utilization of opioid agonist therapy (OAT), and assess factors associated with utilization of OAT, among persons who inject drugs (PWID) in the Seattle metropolitan area. METHODS: We used data from the 2015 National HIV Behavioral Surveillance (NHBS) system among PWID in the Seattle area...
August 10, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28794985/vertical-gaze-palsy-due-to-medication-error
#10
Shishir Rao, Meghan Harper-Shankie, Rajkumar Agarwal
We present a teenage boy with recent onset of seizures, who was erroneously treated with a large dose of an antiseizure medication as a result of drug mix-up. The ensuing drug toxicity caused vertical gaze palsy, an unusual manifestation related to overdose of the agent. Timely recognition of the error and discontinuation of the drug resulted in complete recovery to baseline.
2017: Epilepsy & Behavior Case Reports
https://www.readbyqxmd.com/read/28794966/synthetic-cannabinoid-induced-acute-respiratory-depression-case-series-and-literature-review
#11
Mark Henry Alon, Margaret Olibrice Saint-Fleur
Synthetic Cannabinoids are a street drug that is widely attainable and cheap compared to natural cannabis, and has variable potency and unpredictable effects with no commercially available diagnostic test to confirm its presence. Similar to natural cannabis, Synthetic Cannabinoid intoxication can present in several ways with the most common emergency room presentations to be of neurologic and psychiatric manifestation. The respiratory depressive effect of Synthetic Cannabinoids has not been well documented in medical literature...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28792293/the-opioid-epidemic-challenges-of-sustained-remission
#12
Nitin Chopra, Lauren H Marasa
Opioid use disorder is a growing epidemic, with an alarming number of associated deaths. In 2014, in the United States, 18,893 lethal overdoses were related to prescription opioids and 10,574 due to heroin. Despite the growing number of treatment options for substance use disorders, which are chronic, relapsing-remitting conditions, relapse rates remain as high as 91%. In the United States, 7.5 million children reside with at least one patient who abuses drugs or alcohol. Mothers are twice as likely to lose custody of their children...
March 2017: International Journal of Psychiatry in Medicine
https://www.readbyqxmd.com/read/28777878/a-multi-analyte-approach-to-help-in-assessing-the-severity-of-acute-poisonings-development-and-validation-of-a-fast-lc-ms-ms-quantification-approach-for-45-drugs-and-relevant-metabolites-with-one-point-calibration
#13
Julian A Michely, Hans H Maurer
In emergency toxicology, diagnosis, monitoring of the efficiency of detoxification, and estimating the prognosis of acute poisonings are important tasks. Comprehensive screening and quantification of relevant substances by gas chromatography-mass spectrometry (GC-MS) or liquid chromatography-mass spectrometry (LC-MS) help in assessing the severity of most acute poisonings. Turnaround time for such analyses must be short enough for having impact on clinical decisions. Therefore, a multi-analyte LC-MS/MS approach with a 5-min gradient was developed and validated for 45 drugs and active metabolites as complement to an existing GC-MS approach using the same liquid-liquid extraction...
August 4, 2017: Drug Testing and Analysis
https://www.readbyqxmd.com/read/28772173/heroin-use-onset-among-nonmedical-prescription-opioid-users-in-the-club-scene
#14
Hilary L Surratt, Steven P Kurtz, Mance Buttram, Maria A Levi-Minzi, Maria E Pagano, Theodore J Cicero
BACKGROUND: Nonmedical prescription opioid use (NMPOU) is well documented among participants in the club scene, yet prior studies have not examined transition to heroin use. We prospectively examined heroin initiation among a sample of young adults with drug involvement associated with participation in the club scene, to understand factors that influence transition from NMPOU to heroin and to identify opportunities for intervention. METHODS: Data were drawn from a randomized trial that enrolled 750 Miami-based club and prescription drug users through respondent driven sampling, and tested the efficacy of assessment interventions in reducing risk...
July 26, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28772108/did-the-great-recession-affect-mortality-rates-in-the-metropolitan-united-states-effects-on-mortality-by-age-gender-and-cause-of-death
#15
Erin C Strumpf, Thomas J Charters, Sam Harper, Arijit Nandi
OBJECTIVES: Mortality rates generally decline during economic recessions in high-income countries, however gaps remain in our understanding of the underlying mechanisms. This study estimates the impacts of increases in unemployment rates on both all-cause and cause-specific mortality across U.S. metropolitan regions during the Great Recession. METHODS: We estimate the effects of economic conditions during the recent and severe recessionary period on mortality, including differences by age and gender subgroups, using fixed effects regression models...
July 21, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28770975/paracetamol-acetaminophen-for-chronic-non-cancer-pain-in-children-and-adolescents
#16
REVIEW
Tess E Cooper, Emma Fisher, Brian Anderson, Nick Mr Wilkinson, David G Williams, Christopher Eccleston
BACKGROUND: Pain is a common feature of childhood and adolescence around the world, and for many young people, that pain is chronic. The World Health Organization guidelines for pharmacological treatments for children's persisting pain acknowledge that pain in children is a major public health concern of high significance in most parts of the world. While in the past, pain was largely dismissed and was frequently left untreated, views on children's pain have changed over time, and relief of pain is now seen as important...
August 2, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28770276/a-comparative-study-of-qt-prolongation-with-serotonin-reuptake-inhibitors
#17
Ana Ojero-Senard, Justine Benevent, Emmanuelle Bondon-Guitton, Geneviève Durrieu, Leila Chebane, Melanie Araujo, Francois Montastruc, Jean-Louis Montastruc
BACKGROUND: QT interval prolongations were described with citalopram and escitalopram. However, the effects of the other serotonin reuptake inhibitors (SRIs) remained discussed. In order to identify a putative signal with other SRIs, the present study investigates the reports of QT interval prolongation with SRIs in two pharmacovigilance databases (PVDB). METHODS: Two kinds of investigations were performed: (1) a comparative study in VigiBase®, the WHO PVDB, where notifications of QT prolongation with six SRIs (citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline) were selected...
August 3, 2017: Psychopharmacology
https://www.readbyqxmd.com/read/28768409/opiates-and-plasticity-in-the-ventral-tegmental-area
#18
Ludovic D Langlois, Fereshteh S Nugent
Opioids are among the most effective pain relievers; however, their abuse has been on the rise worldwide evident from an alarming increase in accidental opioid overdoses. This demands for an urgent increase in scientific endeavors for better understanding of main cellular mechanisms and circuits involved in opiate addiction. Preclinical studies strongly suggest that memories associated with positive and negative opioid experiences are critical in promoting compulsive opiate-seeking and opiate-taking behaviors, and relapse...
August 16, 2017: ACS Chemical Neuroscience
https://www.readbyqxmd.com/read/28767538/two-fatal-intoxications-due-to-tramadol-alone-autopsy-case-reports-and-review-of-the-literature
#19
Sara Gioia, Massimo Lancia, Mauro Bacci, Fabio Suadoni
Since tramadol was marketed, it has been widely prescribed as a pain killer because of its relatively safe profile among opioids.Nevertheless, intoxication can occur: overdose can lead to fatal outcomes mostly in association with other drugs, via the potential interaction with serotonergic antidepressant medications, as well as the potential for increased central nervous system (CNS) depression.Fatal outcomes only attributable to tramadol are a rare entity. In this case report, 2 fatal cases are described due to tramadol stand-alone intoxication with peculiar characteristics...
August 1, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28766385/paracetamol-overdose-induced-oxidative-stress-toxicity-metabolism-and-protective-effects-of-various-compounds-in-vivo-and-in-vitro
#20
Xu Wang, Qinghua Wu, Aimei Liu, Arturo Anadón, José-Luis Rodríguez, María-Rosa Martínez-Larrañaga, Zonghui Yuan, María-Aránzazu Martínez
Paracetamol (APAP) is one of the most widely used and popular over-the-counter analgesic and antipyretic drugs in the world when used at therapeutic doses. APAP overdose can cause severe liver injury, liver necrosis and kidney damage in human beings and animals. Many studies indicate that oxidative stress is involved in the various toxicities associated with APAP, and various antioxidants were evaluated to investigate their protective roles against APAP-induced liver and kidney toxicities. To date, almost no review has addressed the APAP toxicity in relation to oxidative stress...
August 16, 2017: Drug Metabolism Reviews
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